This is a simple case to demonstrate the Hahnemann method of essentials required in case taking. Its not complicated and I have stripped out much of the other symptoms that were presented to focus on the complaint.
Members of the IHM will use the Therapeutic pocket Book for analysis, but feel free to use any repertory you have.
You can answer in the comments section.
You have been exposed to colleagues at work who are coughing while in various stages of a flu outbreak. Within a few days, you start coughing. It is dry, non-productive, deep and hacking, worse in cold air, and talking. Coughing produces a very raw sore feeling in the chest, which is relieved by drinking sips of cold water. Coughing can be incessant in trying to bring up mucous from the chest, but expectoration is rare with any bits that come up only making it as far as being swallowed. On one occasion the coughing was so intense that a small amount of urine involuntarily escaped. What remedy would you think of first?
Sars Cov2 pneumonia treated with Homeopathy (Case 2)
All the cases of Dr. Guillermo Zamora presented here come from his daily clinical practice. However, even with the patient’s consent for its publication, some details have been modified to preserve their anonymity.
Professionals at the Institute for Homoeopathic Medicine have already been treating enough COVID-19 cases during this dangerous and very unfortunate pandemic to establish experience. We have also been working from a preventive point of view with very good results.
The homeopathic remedy selected in the case was based on individual symptoms, which means that it works in that case but not in all those who suffer from that disease. The IHM recommendation is that the doctor (and the homeopath who practices genuine homeopathy ) be consulted and that the measures declared by the health authorities be followed.
A homeopathic prescription that is done without modalities might seem somewhat imprecise, however once the concomitant symptoms are successfully combined they can give a clear homoeopathic diagnosis, as seen in the following case:
On January 26, 2021, I was contacted by a retired high command of the Mexican Army. It was his son CS. 53-year-old male, temporary employee who had tested positive for Sars Cov2 antigen. With apparent limitations of the intellect that prevent him from expressing himself adequately due to epilepsy from birth for which he takes Epamin 1-0-2, an indirect interrogation is carried out with the father. It refers to a cough with white expectorations and constant chills day and night. He reports that the day before, he fainted in the morning, losing consciousness only momentarily. For this reason, he was taken to a physician who tried to give an injection with dexamethasone but the patient did not allow it (even becoming somewhat aggressive), which is why he was only prescribed an antibiotic for 8 days. He is seen unusually serious and with little appetite; he asks for something to eat and when it is brought to him he does not eat it. No other information could be collected. Rubrics taken:
Using Boenninghausen’s P&W Therapeutic Pocket Book 1846 in Spanish
520. He does not crave his food, he has no appetite.
523. She cannot eat, she is always full and without appetite, and when she eats anything, she feels disgusted, even vomiting.
957. Expectoration of whitish mucus. [Gll.]
959. Thick, whitish yellow expectoration with violent cough.
1428. Sudden failure of strength, like fainting; she has to hold onto something; at the same time, blurred vision for half an hour.
1571. Chill (after 14 days).
1575. Continuous chill with sensitive coldness throughout the body, worse towards evening.
1597. Chills every day.
Rx.-Lycopodium Clavatum 30c Solution.
On January 27, considerable improvement is reported in the morning, the patient has eaten well and has a better face, but in the afternoon he returns to the state he was in. The father is asked to get a pulse oximeter. Oxygen saturation results in 83. The unsuccessful search for oxygen begins. The peak of the pandemic in the region has reached its maximums. There are no oxygen tanks or concentrators available. There are no beds available in hospitals. People emigrating to other states looking for a place to intern. The situation is critical. However, contact is made with the municipal government where there are some reserves of the essential element and the patient is registered in line for a later call once patients with lower records and in more critical condition are first treated at the discretion of a doctor assigned by the government in turn. Homeopathic treatment continues.
January 28- Simple chest CT is ordered:
In the lung window, parahilar bronchiectasis is observed, an area of greater right parahilar density, poorly defined with reticular images in relation to interstitial pneumonia or atypical pneumonitis. Bilateral intracisural pleurisy.
We can also take a look at Cyrus Maxwell Boger’s Boenninghausen´s Repertory in the chapter Chest-Inner Chest-Phenomena-Pneumonia. It is not recommended but only out of curiosity. One can observe remedies that were useful to the great masters in pneumonia:
Rx.-Lyc 30c Solution
Fortunately, the oxygen saturation has started to rise: 85. The patient eats well and has a better face.
Through a punctual and daily log reported by the father at 8:00 a.m. and 4:00 p.m., it is observed that saturation has gradually increased by 1-2 units per day. Today 93-94. It is worth mentioning that the interval of repetition of the doses of the homeopathic remedy was carried out with admirable discipline and without putting any obstacles to the therapy.
Painful constipation is reported. Diet is recommended.
Oxygen saturation 96-97. Clinic, Laboratories and Cabinet indicating remission of the pathology.
This case demonstrates four significant points:
1. Not always a case shows pathognomonic symptoms of the pathology in question. Here there were never, bouts of suffocation or suffocation, fever, chest pain, loss of taste or smell, etc. and yet the patient had pneumonia. Probably the underlying pathology or the anticonvulsant treatment suppressed some of these symptoms. Either way common sense and medical knowledge must be on the alert.
2. The effective application of Boenninghausen’s Therapeutic Pocket Book requires a complete understanding of the meaning of the rubrics and their applicability in each clinical situation.
3. Even in the absence of modalities, the precise combination of the symptoms of the current illness with the concomitant symptoms that present independently, together can provide a sufficient differential for homoeopathic diagnosis after consultation of Materia Medica Pura.
4. The use of advanced technologies such as tomography provides us with greater planimetric precision of the lesions, in this case of the thorax, which gives us an advantage in defining the location that is more akin to some remedies than others.
Still, it’s always good to keep in mind trying to define each of the symptoms as much as possible.
This is to show that disease progression occurs and thus remedy prescriptions change with new SX.
It is important to note that the remedies I chose are not’ classic’ muscle or twist remedies, but are base solely on the sx expressed and noted. The patient lives 6000 miles away from me…. Usually keeps pain and injury sensations for a couple of weeks…
I was talking with the student who told me of this case, and I decided to write it up for her as a reminder of her first CASE taking and prescription. This student has studied the repertory very hard, to understand the meaning of the rubrics. English is her second language as with members of the Hong Kong Academy so I am doubly impressed with the efforts.
A family member caught a cold. She had a bland watery discharge from the nose. Body felt OK but eyes were tired, wanting to close which felt better. Appetite normal, Not much thirst but found herself wanting to drink water. Also had a chilliness internally, and feeling cold. There was a small cough present but not definable. As there were 121 remedies in cough rubric, it was left out because the other SX would cover.
Based on this, a careful evaluation of the sx led to this prescription.
So what happened? Within a day all sx cleared up. However, The patient had a Chicken Pie the next day and a cough developed.
Her SX were:
1. feeling itchy in throat
2. cough but no expectoration
3. feeling better after water
4. feel like something in throat
5. saliva more than normal
6. feeling cold.
She phoned me at this point, a little disheartened thinking that perhaps she had failed, so I spent time showing her how disease progresses and changes with SX and how we have to follow them as they develop. She was more than happy and competent to go back and re evaluate. I asked her to look at original rubric list and remove SX that were no longer there and add new Sx.
She came to this rep chart.
The patient has not been given any medicine due to not being around, but on reading the MM the student feels Phos fits the picture better than Nux now.
When a student has learned to trust the Materia Medica as the final arbiter in a case, I know that they have understood. Makes me very happy.
Female age 35. Computer software writer. Pleasant personality, outgoing, no physical problems found on examination.
Feb 2017, presented with a feeling daily malaise and sickness. She had just started a new job 3 months ago and the problem began one week after commencing. She did not feel stressed or anxious with the job and actually looked forward to going in every day.
The sick feeling started after breakfast 7am, during the ride to work. It was a general feeling of discomfort and feeling just ‘off’. Occasionally when walking she would have to stop with a sensation of nausea.
When sat at her desk, she had a sensation of mild dizziness which ameliorated when she got up and did another task.
She complained of a recurring toothache for which the dentist could find no causation.
Upon enquiry as to the foods she ate, it seemed that she had begun experimenting with changing her diet to see if foods were the problem. She took orange juice, yoghurt, cereals or toast.
She drank about 3 cups of coffee a day. Upon enquiry as to the type of coffee, she said it was Instant as the coffee machine had broken and the management were a little slow in replacing the machine.
In my experience, in some people, coffee especially instant coffee (primarily consisting of the stronger and more bitter Robusta berries) can aggravate the digestive system very strongly. It can cause nausea, retching, a sense of unwellness, vertigo during sitting upright and many other symptoms. One remedy that can produce these symptoms exactly is Chamomilla. I did not need to repertories this case but have done so based on the EXACT symptoms she presented.
Click on rep chart to enlarge.
I gave her Chamomilla LM 0/1. One single dose. I asked her to NOT drink instant coffee again. She said the result was immediate. Within 10 minutes the sensation of malaise had left. The next day she did not get sick traveling to work and was not dizzy during the day. The coffee machine was replaced a little later and she enquired if she could have coffee again. I told her to try it. There was no untoward reaction from it.
I heard from her in Late April of 2017, no further occurrence of the problem.
I was awakened by a neighbour at 2:30 am who knew that medical practitioners lived in the back of the clinic. She was very concerned about her elderly father who was experiencing difficulties with a fever and a cough.
I also had another problem in as much as the woman who called me was Chinese and did not speak much Spanish or English.
In going into the sick room , I was confronted with an old Chinese male bent over coughing. Fortunately at this time, the womans young 10 year old son came into the room and he spoke both English and Spanish.
When faced with sickness, I always use my senses to collect information. The first thing I observed was that the room had a very musty smell to it. As I approached the patient, it became clear that the patient was perspiring a little and that the odour was coming from him.
In talking to the woman through the son, she told me that her father had a fever for one day and it broke in the early evening. Then a short while later he began coughing and was bringing up a lot of gray mucus. The old man had requested her to make him green tea as he complained of a strong metallic taste with the cough.
We could not find out a reason for the fever so I looked at the symptoms before me.
The cough started AFTER the fever broke.
the expectoration was a grey mucous
a taste of metal
the offensive mold smell from his perspiration.
His daughter helped him to the bathroom and told me that his urine was extremely dark.
Based on these symptoms:
I gave Nux Vomica LM 0/1 in 3 doses every 20 minutes. By the third dose his cough had stopped and he fell peacefully asleep. In the morning he felt a little weak but was well on the mend.
It is true that the TPB only contains 125 remedies for evaluation. However, in practice, it is also true that most practitioners do not know the value or scope of most remedial actions. It is amazing to find out the curative power of remedies that we have a pre- conceived opinion of as to its field of action, and see it restore sickness to health outside of our comfort zone.
Let me give an example of a recent case with few symptoms. I tried a few remedies in the first 2 days of the presented fever, and nothing really worked. In the end I sat down and looked for what could be observed visually.
The patient had a sticky greasy perspiration. Mainly on the left side of his body.
I repertorised these 3 Sx . I saw Bryonia clearly was top in the numerical values and as such I was preparing a dose of LM potency to give…
However, given that numerical values are only an indication of the frequent presence of a symptom in a remedy and not an INTENSITY value, I went back and looked at the patient again and noticed yet another symptom. The perspiration was not clear, it had a brown dirty colour to it on the skin. Discoloured perspiration is not in BRYONIA.
I gave CHINA LM 0/1. Within 4 hours the patient was recovering.
What do we learn from this case? I believe that accuracy in symptom gathering is the requirement of the day. Once gathered, it must be assessed SOLELY on the basis of the symptoms and repertorised ACCURATELY and without prejudice to what we THINK the remedy is. Where a physical SX exists it cannot be ignored if it is a result of the infection.
This is a common complaint from people who move from Kents repertory to the Therapeutic Pocket Book.
In our advanced practitioner course, we spend time showing people the correct way to analyse a case and how to use ‘states’ that reflect the altered disposition of the patient, as opposed to personality symptoms that are not signs of pathology.
The patients original condition was vertigo which came on without obvious causation. It was treated with two remedies which removed 95% of the Vertigo and relieved other symptoms experienced. However and again for no observable reason, an internal anxiety arose and has become the focus of the problem. The patient said that the type of anxiety experienced was something observed before over 40 some years ago, but not troubled overmuch by these symptoms after that.
Briefly, here is a recently received patient note and the analysis of the same.
…..Started feeling a building up of uneasiness. It feels like coldness inside the body. Inside the arms and sometimes the abdomen chest and head. Then apprehensiveness that something isn’t right, something’s going to happen. It keeps on coming, I have to work to relax. Then slight wooziness began which in turn increases the cold sensation. At times the tingling in the buttocks as well (explained he felt the anxiety in his body and currently is in buttocks.) Have to lie in the chair and concentrate on relaxing, which helps, but is very difficult it it gets too bad. My wife had to leave to do some errands, I would rather she had stayed, made me more nervous to have her gone. It seems like this comes from the body coldness sensation first, then the apprehension with no definite thoughts, then wooziness, then everything seems to excite more nervousness.
So here we have a pathological ‘state’ combined with a vertigo. The anxiety is out of proportion and has also spread into any thought that he has where something has not gone correctly as it should have. For example: “….I bought too much meat at the market and now I have bag it and freeze it…aargh!”
Rather than get into the minutiae of his words and try to do a psychological evaluation, I just looked at the expression of his ‘state’ and went to the repertory.
Firstly the symptoms are aggravated by vertigo. He is aggravated, vexed by little things and they produce an anxious state. He becomes restless and feels anxiety in the body. There is a sensation of coldness internally. He desires to not be alone and the presence of someone else is comforting.
This is the entire picture of the pathology experienced. I repertorised in this way.
He had already had Lycopodium which removed the vertigo symptoms, and a quick read of Arsenicum confirmed that this indeed was the remedy to give at this point.
….thanks Gary, I just took it. Seems to be relaxing. I’ll try to go back to bed if I can.